Ravini Lighted Urethral Speculum
The RaViNi is a self-retaining, lighted urethral speculum listed by Surgipros LLC as a urethroplasty retractor; it has been described in female urethroplasty and in posterior-urethral substitution urethroplasty, where its authors state it was built for deep perineal dissection. The listed instrument family includes standard, blunt-suction, over-the-wire Council-tip and extra-long variants.[1][2][5] Match a specific device to anatomy and the procedure.[1][2][5]
Design
- Self-retaining blades hold the urethral corridor open; wider labial or vaginal exposure or an assistant may still be needed.
- Integrated distal light source at the tip. Illuminates the working surface directly, unlike the back-table line-of-sight illumination of an overhead light.
- French calibre sizing. The listed standard RaViNi is 14 Fr, while the Council-tip RaViNi-C is 12 Fr; confirm other dimensions with the current catalog.[5]
- Tip-style variants (see below) for different dissection strategies.
Variant Family
| Variant | Distinguishing feature | Best fit |
|---|---|---|
| RaViNi | 14 Fr standard | Routine female urethroplasty / introital corridor work |
| RaViNi-B | Blunt tip with integrated suction adapter | Blood-and-irrigation-clearing during ongoing dissection; posterior urethroplasty after stricture has been opened[2] |
| RaViNi-C | 12 Fr Council-tip for over-the-wire placement[5] | Initial stricture engagement — the device is passed over a previously placed guidewire, then sequential incisions are made through the stricture until the lumen accepts the larger RaViNi-B[2] |
| RaViNi-π | Extra-long shaft | Deep-corridor exposure where the extra length is appropriate; no comparative outcome advantage established |
Reconstructive-Urology Uses
Female Urethroplasty
The instrument's design problem: the female urethra is short, narrow, and angled cephalad through the introital corridor; conventional vaginal retractors (Heaney, Breisky-Navratil, Auvard weighted speculum) open the vaginal canal but do not provide a self-retaining illuminated channel into the urethra itself. The Ravini operationalizes that specific exposure.
Reported over-the-wire workflow in the demonstrated female case and posterior substitution technique:[1][2]
- Cystoscopy and guidewire placement across the stricture.
- RaViNi-C (over-the-wire, 12 Fr) is advanced into the stricture; sequential incisions are made under direct illumination.
- Once the lumen accommodates a larger calibre, switch to RaViNi-B for the graft inset and full reconstruction.
An AUA 2025 video abstract described seven heterogeneous female-urethroplasty cases, with 5/7 (71%) reported as successful at a median 21.6-month follow-up.[1]
Posterior Urethroplasty / Deep Perineal Dissection
The Kaldany / Cedars / Nikolavsky 2025 technique paper on substitution urethroplasty for posterior urethral stenosis describes RaViNi-C over a wire, followed by RaViNi-B with its blunt suction tip after the lumen accommodates an 18 Fr instrument.[2] Its authors describe improved access and visibility in their technique; comparative benefit has not been demonstrated.
Other Reconstructive Uses
The instrument may be considered when a narrow illuminated urethral corridor is useful in diverticulum, fistula, mesh-excision or female bladder-neck surgery. Conventional vaginal and Lone Star exposure remains relevant; tailor exposure to the defect.[3]
Technique Pearls
- Match the variant to the dissection phase. RaViNi-C over-the-wire for stricture engagement; RaViNi-B once the lumen is open enough for the blunt-suction tip.[2]
- Position for the target corridor according to the operative technique and patient-specific constraints; high lithotomy is one option.
- Keep the illuminated tip clear if obscured by blood or debris, following the instrument's handling instructions.
- Pair with a Lone Star ring for vulvar-skin retraction; the Ravini exposes the urethra but does not handle vulvar tissue.
- Recheck blade position intermittently during prolonged dissection; no fixed 20–30-minute interval is established by the cited sources.
Limitations
- Single-axis exposure. The Ravini opens the urethral corridor but does not retract the vaginal walls or labia; supplement with a Lone Star or assistant retraction for the wider field.
- No published comparative data versus nasal speculum (Hoag 2016 vaginal-sparing technique[4]) or versus ring-retractor-only exposure; choice remains operator preference.
- Acquisition and processing vary by model and institutional arrangement; verify the current vendor listing and model-specific reprocessing instructions before procurement or use.[5]
Alternatives for Female-Urethroplasty Exposure
| Instrument | Self-retaining | Integrated light | Best fit |
|---|---|---|---|
| Ravini lighted speculum | Yes | Yes | Purpose-built option where available[1] |
| Nasal speculum | No (assistant-held) | No | Low-cost / non-Ravini institutions; Hoag 2016 vaginal-sparing ventral BMG technique[4] |
| Weighted vaginal speculum + Scott / Lone Star | Yes (gravity / elastic) | No | Diverticulum resection, broader vaginal exposure when urethral corridor is not the limiting step[3] |
| Heaney / Breisky-Navratil retractor | No (handheld) | No | Apical vaginal exposure; does not address introital-urethral corridor |
Historical / Manufacturer Context
The RaViNi family is listed by Surgipros LLC. The Kaldany 2025 paper notes that posterior-urethroplasty use had not previously been published as of that report.[2][5]
See also: Female Urethra, Female Urethroplasty, Female Urethral Diverticulum Repair, Lone Star Retractor, Nasal Speculum.
References
1. Bearrick E, Cedars B, Li G, Nikolavsky D. Use of self-retaining lighted urethral speculum in female urethroplasty. J Urol. 2025;213(5S):e536, V06-11 (video abstract). doi:10.1097/01.JU.0001109896.28753.9f.11
2. Kaldany A, Cedars B, Nikolavsky D. Substitution urethroplasty for posterior urethral stenosis. Transl Androl Urol. 2025;14(12):3962–3974. doi:10.21037/tau-2025-566
3. Crescenze IM, Goldman HB. "Female urethral diverticulum: current diagnosis and management." Curr Urol Rep. 2015;16(10):71. doi:10.1007/s11934-015-0540-8
4. Hoag N, Gani J, Chee J. "Vaginal-sparing ventral buccal mucosal graft urethroplasty for female urethral stricture: a novel modification of surgical technique." Investig Clin Urol. 2016;57(4):298–302. doi:10.4111/icu.2016.57.4.298
5. Surgipros LLC. RaViNi illuminated urethroplasty retractors, current vendor catalog. Model listing and specifications; procurement and processing should follow the supplied current device documentation.